Diabetes doubles among pregnant women, teens

Diabetes among pregnant women and teenagers more than doubled in six years, a concern among physicians who say the disease increases the chance of miscarriages and birth defects, according to a study released today.

Of the more than 175,000 patients who gave birth in about a dozen Kaiser Permanente hospitals from 1999 to 2005, twice as many births were to women with TypeI and TypeII diabetes, according to a Kaiser Permanente study published in the May issue of Diabetes Care. The American Diabetes Association funded the study.

The conditions are unlike gestational diabetes, which develops during pregnancy but can disappear after a baby is born.

Today's study is the largest to look at pre-pregnancy diabetes, researchers said.

"More young women are entering their reproductive years with diabetes, in part due to the fact that our society has become more overweight and obese," said Jean Lawrence, the study's author and a research scientist at Kaiser Permanente's Department of Research and Evaluation.

"While we currently don't know how to prevent TypeI diabetes, the steps to reducing risk of TypeII diabetes must start before childbearing years: healthy eating, active living and maintaining a healthy weight. These habits should begin in childhood and continue through adulthood."

Women with diabetes who do get pregnant said they face a host of challenges trying to maintain their blood-sugar levels.

"It was difficult because with the hormones, you become more resistant to insulin," said Grace Montoya, a 37-year-old Valencia resident, who has TypeI diabetes. She gave birth to her first child nearly seven years ago. It was a planned pregnancy, but she had to remain vigilant.

Montoya, a critical care nurse at Northridge Hospital Medical Center, said she is expecting her second child in a few weeks. She tests her blood-sugar levels eight to 10 times a day.

"It's the constant balance of what you are eating and getting enough exercise and the amount of insulin that you're taking to get your blood sugars in control," she said. "As I became more pregnant, I became more resistant to the insulin."

She has been living with TypeI diabetes since she was 16 years old.

"When you're pregnant, you have to be more on top of it because the baby could have abnormalities," she said.

Health experts say that women with pre-existing diabetes are more likely to have miscarriages and babies with birth defects than women who do not have diabetes.

"When these women get pregnant, their level of control becomes very poor," said Dr. Shalesh Gupta, a perinatologist with Kaiser Permanente's Panorama City facility.

"Once they get pregnant, complications like a miscarriage can increase because the blood-sugar levels get higher, placing the babies at risk," he said.

African-American, Hispanic and Asian/Pacific Islander women were more likely to have diabetes before pregnancy than Caucasian women.

"Limiting obesity is the best way to reduce the rising incidence of TypeII diabetes in young women," said Dr. David Sacks, a Kaiser Permanente perinatologist who co-wrote the study.

Sacks treats up to 50 diabetic mothers-to-be a year. "We've become a more sedentary and obese society so naturally TypeII diabetes has risen, too," he said. "For Latinas, the risk is even higher for developing TypeII diabetes, so it's really important to defy family history and work on achieving a healthy weight."